Erythropoietin administration facilitates return of spontaneous circulation and improves survival in a pig model of cardiac arrest

• Published in: The American journal of emergency medicine 2014-08, Vol.32 (8), p.871-877
• Main Authors: Vasileiou, Panagiotis V.S., MSc, Xanthos, Theodoros, PhD, Barouxis, Dimitrios, MSc, Pantazopoulos, Charalampos, MD, Papalois, Apostolos E., PhD, Lelovas, Paulos, PhD, Kotsilianou, Olympia, MD, Pliatsika, Paraskevi, MSc, Kouskouni, Evaggelia, PhD, Iacovidou, Nicoletta, PhD
• Format: Article
• Language: English
• Subjects: Animals; Blood Circulation - drug effects; Blood Pressure - drug effects; Brain research; Cardiac arrest; Cardiopulmonary Resuscitation; CPR; Disease Models, Animal; Emergency; Emergency medical care; Erythropoietin - therapeutic use; Female; Free radicals; Heart Arrest - drug therapy; Heart Arrest - etiology; Hogs; Sodium chloride; Survival; Swine; Treatment Outcome; Ventilators; Ventricular Fibrillation - complications
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2014.04.036

Abstract Background In addition to its role in the endogenous control of erythropoiesis, recombinant human erythropoietin (rh-EPO) has been shown to exert tissue protective properties in various experimental models. However, its role in the cardiac arrest (CA) setting has not yet been adequately investigated. Aim The aim of this study is to examine the effect of rh-EPO in a pig model of ventricular fibrillation (VF)-induced CA. Methods Ventricular fibrillation was electrically induced in 20 piglets and maintained untreated for 8 minutes before attempting resuscitation. Animals were randomized to receive rh-EPO (5000 IU/kg, erythropoietin [EPO] group, n = 10) immediately before the initiation of chest compressions or to receive 0.9% Sodium chloride solution instead (control group, n = 10). Results Compared with the control, the EPO group had higher rates of return of spontaneous circulation (ROSC) (100% vs 60%, P = .011) and higher 48-hour survival (100% vs 40%, P = .001). Diastolic aortic pressure and coronary perfusion pressure during cardiopulmonary resuscitation were significantly higher in the EPO group compared with the control group. Erythropoietin-treated animals required fewer number of shocks in comparison with animals that received normal saline ( P = .04). Furthermore, the neurologic alertness score was higher in the EPO group compared with that of the control group at 24 ( P = .004) and 48 hours ( P = .021). Conclusion Administration of rh-EPO in a pig model of VF-induced CA just before reperfusion facilitates ROSC and improves survival rates as well as hemodynamic variables.